title: Effectiveness of a multifactorial handwashing program to reduce school absenteeism due to acute gastroenteritis.
abstract: BACKGROUND
  Acute gastroenteritis (AGE) is one of the most common diseases among children and an important cause of school absenteeism. The aim of this study was to assess the effectiveness of a handwashing program using hand sanitizers for the prevention of school absenteeism due to AGE.
  
  
  METHODS
  A randomized, controlled and open study of a sample of 1341 children between 4 and 12 years of age, attending 5 state schools in Almería (Spain), with an 8-month follow up (academic year). The experimental group (EG) washed their hands with soap and water, complementing this with the use of a hand sanitizer, and the control group (CG) followed the usual handwashing procedure. Absenteeism rates due GI were compared between the 2 groups through the multivariate Poisson regression analysis. Percent days absent in both groups were compared with a Z-test.
  
  
  RESULTS
  446 cases of school absenteeism due to AGE were registered. The school children from the EG had a 36% lower risk of absenteeism due to AGE (IRR: 0.64, 95% confidence interval: 0.52-0.78) and a decrease in absenteeism of 0.13 episodes/child/academic year (0.27 of EG vs 0.40 CG/episodes/child/academic year, P < 0.001). Pupils missed 725 school days due to AGE and absent days was significantly lower in the EG (EG: 0.31%, 95% confidence interval: 0.28-0.35 vs. CG: 0.44%, 95% confidence interval: 0.40-0.48, P < 0.001).
  
  
  CONCLUSIONS
  The use of hand sanitizer as a complement to handwashing with soap is an efficient measure to reduce absent days and the number of school absenteeism cases due to AGE.
authors.affiliation: From the *Distrito Sanitario de Atención Primaria Almería; †Servicio de Pediatría, Hospital Torrecárdenas; ‡Universidad de Almería, Almería, España; §Statistician at Fundación para la Investigación Biosanitaria Andalucía Oriental Alejandro Otero (FIBAO), Hospital Torrecárdenas, Almería, España.
authors.forename: Ernestina
authors.initials: E
authors.lastname: Azor-Martínez
authors.forename: Elena
authors.initials: E
authors.lastname: Cobos-Carrascosa
authors.forename: Francisco
authors.initials: F
authors.lastname: Gimenez-Sanchez
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Martínez-López
authors.forename: Pablo
authors.initials: P
authors.lastname: Garrido-Fernández
authors.forename: Joaquin
authors.initials: J
authors.lastname: Santisteban-Martínez
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Seijas-Vazquez
authors.forename: Maria Amparo
authors.initials: MA
authors.lastname: Campos-Fernandez
authors.forename: Antonio
authors.initials: A
authors.lastname: Bonillo-Perales
mesh_terms: D000041:Absenteeism; D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control*; D006235:Hand Disinfection / Q000379:methods*; D064548:Hand Sanitizers; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D012574:Schools; D013030:Spain / Q000453:epidemiology; D013334:Students / Q000706:statistics & numerical data*
chemical_list: D064548:Hand Sanitizers